Third Party Payor and Managed Care Follow-up of Inpatient and Outpatient Claims, Denial Management / Denial Reversal Specialists
Upon referral, RTR reviews each account and groups all accounts by Insurance Carrier. The accounts are then assigned to teams specializing in the corresponding Insurance Carrier. These specialized teams ensure a comprehensive contractual knowledge unique to each Insurance Carrier - allowing for expedited claim times through enhanced efficiency.
RTR’s specialized teams of experienced staff pursue all reasoning behind lack of payment, from the Insurance Carrier, before seeking to overturn the Insurance Carrier’s rejection to payment.In the event an Insurance Carrier stands by their erroneous Rejection and/or Underpayment:
- RTR will construct and provide the Insurance Carrier with a detailed reasoning, including contractual obligations, defending the request for payment from the Insurance Carrier.
- RTR, with the Client's permission, will file a formal complaint with the Insurance Carrier’s State Department of Insurance requesting paid services be contractually reviewed. In instances of overpayment, a letter will be issued to the Insurance Carrier requesting a contractual review.
From start to finish, RTR’s specialized team’s leverage their unique experience and knowledge, specific to each Insurance Carrier, to construct the most thorough reasoning and effective solution for each account.